Type-2 Diabetes Mellitus is a complex, chronic medical condition that may have serious health implications if not managed properly. Sustained elevated blood glucose levels can lead to complications such as cardiovascular and renal diseases. Lowering hemoglobin A1C (HbA1c) levels to less than 7% has been shown to reduce microvascular and macro vascular complications. The purpose of this study was to determine the impact of a chronic care model on a population of indigent Hispanic patients in a rural area. The model of care included diet modification, walking for 30 minutes at least five times per week, foot examinations, medication management, and patient and family education using the teach-back method. The model was implemented at Nurse Practitioner led clinic was worked in collaboration with NP students from a local college. The model of care utilized structured guidelines that were printed in English and Spanish to enhance consistency in education taught to all patients visiting the clinic. The data collected showed a significant reduction in the number of patients with a HbA1c levels greater 7% during a six month to two-year period.
Methods:
A retrospective chart review of indigent patients diagnosed with Type II Diabetes (N = 138) was completed. Inclusion criteria for the audit was indigent patients diagnosed with Type II Diabetes during a period spanning from 2015-2017. A chart audit tool was utilized to collect data. Information documented in the tool included demographic data, employment status, education level, history of smoking, blood pressure levels, lipid profile, current HgbA1c level, BMI, date of visit and medications. Data was collected from medical records and the clinic’s online medical database. To determine if there was a statistically significant reduction in patient HbA1c levels a parametric t-test was carried out.
Results:
The sample population was Hispanic patients, with 67 males and 71 females; (n = 138). Initially, the majority of the populations HbA1c levels did not meet the recommended goal of less than 7% (n = 126; 91.3%). However 41 patients (29.7%) met the recommended level by the end of the two year mark. In addition, the results showed a statistically significant improvement in the patients’ HbA1c levels over the course of the two year period (p ≤ 0.001).
Conclusion:
Results from this study support a care model utilizing free and low cost diabetes medication, diet and exercise therapy reduced HbA1c levels among an indigent patients population. These results can be used to contribute to the body of knowledge regarding ongoing care of indigent patients with Type II Diabetes. Results can be considered a catalyst for change when advocating for resources to support chronic care using a model of care for indigent patient populations that include free and low cost medication therapy in a clinic led by an NP working in collaboration with NP students.
Purpose:
Type-2 Diabetes Mellitus is a complex, chronic medical condition that may have serious health implications if not managed properly. Sustained elevated blood glucose levels can lead to complications such as cardiovascular and renal diseases. Lowering hemoglobin A1C (HbA1c) levels to less than 7% has been shown to reduce microvascular and macro vascular complications. The purpose of this study was to determine the impact of a chronic care model on a population of indigent Hispanic patients in a rural area. The model of care included diet modification, walking for 30 minutes at least five times per week, foot examinations, medication management, and patient and family education using the teach-back method. The model was implemented at Nurse Practitioner led clinic was worked in collaboration with NP students from a local college. The model of care utilized structured guidelines that were printed in English and Spanish to enhance consistency in education taught to all patients visiting the clinic. The data collected showed a significant reduction in the number of patients with a HbA1c levels greater 7% during a six month to two-year period.
Methods:
A retrospective chart review of indigent patients diagnosed with Type II Diabetes (N = 138) was completed. Inclusion criteria for the audit was indigent patients diagnosed with Type II Diabetes during a period spanning from 2015-2017. A chart audit tool was utilized to collect data. Information documented in the tool included demographic data, employment status, education level, history of smoking, blood pressure levels, lipid profile, current HgbA1c level, BMI, date of visit and medications. Data was collected from medical records and the clinic’s online medical database. To determine if there was a statistically significant reduction in patient HbA1c levels a parametric t-test was carried out.
Results:
The sample population was Hispanic patients, with 67 males and 71 females; (n = 138). Initially, the majority of the populations HbA1c levels did not meet the recommended goal of less than 7% (n = 126; 91.3%). However 41 patients (29.7%) met the recommended level by the end of the two year mark. In addition, the results showed a statistically significant improvement in the patients’ HbA1c levels over the course of the two year period (p ≤ 0.001).
Conclusion:
Results from this study support a care model utilizing free and low cost diabetes medication, diet and exercise therapy reduced HbA1c levels among an indigent patients population. These results can be used to contribute to the body of knowledge regarding ongoing care of indigent patients with Type II Diabetes. Results can be considered a catalyst for change when advocating for resources to support chronic care using a model of care for indigent patient populations that include free and low cost medication therapy in a clinic led by an NP working in collaboration with NP students.Purpose:
Type-2 Diabetes Mellitus is a complex, chronic medical condition that may have serious health implications if not managed properly. Sustained elevated blood glucose levels can lead to complications such as cardiovascular and renal diseases. Lowering hemoglobin A1C (HbA1c) levels to less than 7% has been shown to reduce microvascular and macro vascular complications. The purpose of this study was to determine the impact of a chronic care model on a population of indigent Hispanic patients in a rural area. The model of care included diet modification, walking for 30 minutes at least five times per week, foot examinations, medication management, and patient and family education using the teach-back method. The model was implemented at Nurse Practitioner led clinic was worked in collaboration with NP students from a local college. The model of care utilized structured guidelines that were printed in English and Spanish to enhance consistency in education taught to all patients visiting the clinic. The data collected showed a significant reduction in the number of patients with a HbA1c levels greater 7% during a six month to two-year period.
Methods:
A retrospective chart review of indigent patients diagnosed with Type II Diabetes (N = 138) was completed. Inclusion criteria for the audit was indigent patients diagnosed with Type II Diabetes during a period spanning from 2015-2017. A chart audit tool was utilized to collect data. Information documented in the tool included demographic data, employment status, education level, history of smoking, blood pressure levels, lipid profile, current HgbA1c level, BMI, date of visit and medications. Data was collected from medical records and the clinic’s online medical database. To determine if there was a statistically significant reduction in patient HbA1c levels a parametric t-test was carried out.
Results:
The sample population was Hispanic patients, with 67 males and 71 females; (n = 138). Initially, the majority of the populations HbA1c levels did not meet the recommended goal of less than 7% (n = 126; 91.3%). However 41 patients (29.7%) met the recommended level by the end of the two year mark. In addition, the results showed a statistically significant improvement in the patients’ HbA1c levels over the course of the two year period (p ≤ 0.001).
Conclusion:
Results from this study support a care model utilizing free and low cost diabetes medication, diet and exercise therapy reduced HbA1c levels among an indigent patients population. These results can be used to contribute to the body of knowledge regarding ongoing care of indigent patients with Type II Diabetes. Results can be considered a catalyst for change when advocating for resources to support chronic care using a model of care for indigent patient populations that include free and low cost medication therapy in a clinic led by an NP working in collaboration with NP students.